A large fontanel in a child: the size, timing of closure
At birth, the child has elastic and at the same time strong cranial bones, which connects a large and small fontanel, as well as seams, they also act as natural shock absorbers. By their condition, it is possible to determine the presence of ICP or the nature of the course of labor. When passing through the birth canal, the skull of the newborn is significantly deformed by imposing bones on each other. This reduces the risk of injury for both the baby and the mother. Young parents can somewhat frighten the wrong shape of the head, but do not worry, because after a while it will get its usual shape.
Why you need a fontanel
A large fontanel in the child ensures unimpeded development of the brain. And its most active growth is, as we know, for the first year of life, just at the time when the skull has a space covered by a membrane.
Thanks to the fontanel, it is possible to conduct a brain examination without using complicated techniques and with the least discomfort for the baby. Neurosonography reveals the consequences of trauma, hemorrhages, various neoplasms, and changes in brain structures at the earliest stage. Among other functions, it is worth mentioning the provision of thermoregulation. The large fontanel in the child, in particular the membrane closing it, cools the body when the body temperature reaches 38 degrees. The additional mechanism of thermoregulation significantly reduces the likelihood of brain edema and seizures, which can be caused by high fever. It also acts as a kind of shock absorber during the falls, without which the first steps are not enough.
The timing of the closure of the great fontanel in children
The average size is 2х2 cm, the fontanel is located on the vertex and has a rhomboid shape. With age, the cranial bones coalesce and by the year it disappears. But all children have different development, so this process can last up to 18-20 months. This should not cause concern, provided other indicators are appropriate to the norm.
The skull of a newborn is distinguished by the presence of a small fontanel on the occiput, which is much smaller. Almost all children are closed immediately after birth, it can be found in infants who were born before the deadline. In this case, its full adhesion is observed after 4-8 weeks.
Pulsation and the size of the fontanel are of particular importance and allow doctors to assess the condition of the child. Due to its functional load, later or later, overgrowth in some cases may be a symptom of the pathological growth of cranial bones.
The course of pregnancy
Nutrition of a woman during pregnancy affects the phosphoric-calcium metabolism of the child, which affects the time of the growth of the fontanel. A large fontanel in a child can be dense, small in size and have a tendency to close quickly, if the expectant mother used too many dairy products with simultaneous intake of vitamins. This is one of the reasons for the need to strictly adhere to the established rate, selected by a gynecologist depending on the period of pregnancy. It is also worth noting that an excess of calcium contributes to the early aging of the placenta.
In addition, due to the limitation of volume for brain growth, there is an impact on its development.
Excess calcium in most cases is the cause of early overgrowing of the fontanel, with its deficiency it closes later than the established time. Both cases are an occasion for additional examination, since a low level of calcium is caused by an insufficient amount of vitamin D, and its deficiency also contributes to the occurrence of a disease such as rickets. Because of it, the bone tissue begins to change, the legs become less even and the gait is disturbed. Other symptoms include baldness of the occipital part of the head, excessive sweating, characterized by an acidic odor, poor sleep. Normalization of the exchange of calcium-phosphorus elements prevents premature fusion of the edges of the fontanel.
If the large fontanel of newborns closes too early, it may indicate the probability of microcephaly, craniostenosis, and if there is a discrepancy after closure, special attention should be paid to possible increased cranial pressure.
A large fontanel in newborns should have dimensions within 1-3 cm. Exceeding this parameter may indicate the presence of infectious diseases, injuries received during labor, hypoxia during pregnancy and impaired fluid outflow in the cerebral ventricles. In addition, children born before the term, as well as having malformations, endocrine disorders and improper metabolism, can also have a large fontanel.
When to see a doctor
If there is a discrepancy, you will need to take tests to determine the level of calcium in the urine and blood and to undergo a medical additional examination. This is due to the fact that rickets, which is a frequent cause of the wrong size of the fontanel, leads to deformation of the bones, a decrease in the overall muscle tone and changes in the work of the nervous system. In this case, the appearance of constipation due to general muscle weakness. The child should be shown to the neurologist, if the psychomotor development and fontanel do not correspond to the age, more often the reason for this is intracranial hypertension, which is eliminated by special drugs. In this case, parents should monitor the development of the child and if there is any doubt, contact the pediatrician. The doctor should be aware of any inconsistencies in the norms and anxiety symptoms. For example, frequent crying in a dream and loud cries on waking may indicate a headache caused by high intracranial pressure. Spring at the baby with crying becomes strained, under it there is an arterial pulsation.
Medical examination requires a depressed surface, this indicates the dehydration of the body due to frequent vomiting or diarrhea.
What are moms afraid of
Newly-mouthed parents are often afraid even to accidentally touch the "soft" crown and ask the pediatrician about the need for specific care. The rodlet in the baby, in particular its membrane, can not be damaged by combing the hair or stroking the head, since it is much stronger than it seems. In some cases, diving of a child is undesirable, even when observed by qualified specialists, since the brain is exposed to pressure differences.
When observing the development of crumbs, the ripening of the fontanel should not cause the parents' feelings. Many people are of the opinion that it is possible to accelerate its overgrowing with an increase in the diet of a daily dose of vitamin D and calcium. But such actions will not have any impact in the presence of a genetic predisposition.
In conclusion of the above, it is worth noting the main causes of discordance fontanel established norms:
- Rickets is the most common. But do not look for symptoms of this disease only on condition of long not overgrown crown. The main additional symptom is deformation of the skeleton, in particular, changes in individual parts of the body, for example, legs or chest.
- A large fontanel in a child can also be caused by hypothyroidism. But such a disruption of the thyroid gland manifests itself at the age of 1.5-2 years is rare.
- Hereditary factor. In this case, the timing of the fusion is very blurred and can reach up to 2.5 years. About its presence, one can speak if there are no other signs and at the same time develop according to age.